The Charleston Alcohol Research Center (ARC) at MUSC, which is comprised of researchers in the Departments of Psychiatry and Neuroscience, was recently granted funding from the National Institutes of Health (NIH) through 2025, which will be the Center’s 30^th anniversary. The Center opened in 1995 and is a P50 Center supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). But in light of a dramatic spike in alcohol use/misuse during the COVID-19 pandemic, work conducted in one of the nation’s longest continually funded Alcohol Research Center has become more important than ever.

For more than two decades, the Charleston ARC team has made several notable discoveries regarding alcohol and the brain. For instance, team members found that alcohol disrupts nerve cell functioning and neural network activity in the prefrontal cortex, the area of the brain responsible for decision-making. They’ve also found that activation of the brain in response to alcohol cues is different in individuals with Alcohol Use Disorder (AUD) compared to social drinkers. Findings like these have helped to reinforce the idea that AUD is a brain disorder and not just due to a lack in willpower or a character flaw. 

“We no longer use the term alcoholic because it has negative connotations to it,” said Howard Becker Ph.D., director of the Charleston Alcohol Research Center. “It also emphasizes the fact that this is a medical condition, a brain disorder. Alcohol Use Disorder is something that can be diagnostically determined by a set of criteria about how much and how often you drink.” 

 

Becker explained that AUD can be diagnosed in people who drink too much, too fast and too often. The NIAAA offers a list of questions to help physicians and other health care providers to diagnose AUD in patients.

For those suffering from AUD, the COVID-19 pandemic did them no favors. Whether it was from anxiety about getting sick, losing their jobs or just being confined to their homes more often, alcohol consumption dramatically increased during the pandemic. “Over the course of the 2020, we saw a 40% increase in average monthly intake and a 25% increase in alcohol-related deaths,” Becker said. “Increases in the number of emergency department visits; increases in hospitalizations for alcohol withdrawal/detoxification; and increases in the number of fatalities associated with alcohol driving accidents have also been reported.” 

Becker also said that alcohol is known to suppress the immune system, leaving those with AUD more susceptible to viruses like COVID-19. “Then you add to this this viral pandemic that produced a great deal of mental illness, a lot of stress, distress, despair that only exacerbates the problem,” Becker added.

Becker says that, sadly, less than 10% of people suffering from AUD seek treatment, a statistic that the staff at the Charleston ARC would like to improve. He said there are three kinds of treatment available. 

First, there are three FDA-approved medications that reduce craving for alcohol. There are also behavioral treatments, including cognitive-behavioral therapy, in addition to support groups, like Alcoholics Anonymous. For best results, Becker suggested that these treatments be used in tandem with each other. “None of these are mutually exclusive,” he said. “And most people would say it's probably a good thing to engage in them together.”

 

Additionally, the Charleston ARC offers clinical research studies that may be helpful to understanding and treating AUD more effectively. Clinical research studies in the ARC explore new treatment options that MUSC researchers think might stop the downward spiraling cycle of addiction and lead to better control over alcohol drinking. Currently, the Center has studies testing the effects of new and novel medications as well as use of magnetic stimulation to help those suffering with AUD to gain better control over their unhealthy drinking habits. 

“If people come to the clinic here at MUSC, they are going to receive effective evidence-based treatment modalities, including some of the latest and best treatments that we are developing,” Becker said, referring to the clinical component of the Center. “They can engage in some research projects that really are at the cutting edge of the kinds of therapeutic approaches that hold great promise in helping people battle what is a significant problem in a great number of individuals that we see.” 

Highlights of ARC research discoveries and accomplishments

• Howard Becker, Ph.D.; Raymond Anton, M.D.; Hugh Myrick, M.D.; and Robert Malcolm, M.D., demonstrated unique consequences and novel treatment strategies for people with a history of repeated alcohol detoxifications.

• Kathleen Brady, M.D., Ph.D.; and Carrie Randall, Ph.D., examined treatment strategies best tailored for people presenting with comorbidity of alcohol use disorder (AUD) and depression, anxiety, PTSD.

• Raymond Anton, M.D., developed clinical laboratory procedures to evaluate medication effects on alcohol craving and drinking and examine influence of genetics in response to treatments for AUD with an eye toward establishing a more targeted, personalized treatment approach.

• Howard Becker, Ph.D.; and Marcelo Lopez, Ph.D., established novel models of alcohol dependence and relapse drinking that serve as valuable platforms for identifying and evaluating new and novel treatments for AUD.

• Raymond Anton, M.D.; Hugh Myrick, M.D.; James Prisciandaro, Ph.D.; and Lisa McTeague, Ph.D., used neuroimaging to examine how treatments (medications, transcranial magnetic stimulation) change altered brain activation and chemistry responses to alcohol cues.

• John Woodward, Ph.D.; Judson Chandler, Ph.D.; Patrick Mulholland, PhD.; and Jennifer Rinker, Ph.D., demonstrated that alcohol disrupts specific neural networks in the prefrontal cortex and pathways projecting to other brain regions related to excessive drinking.